The Effect of Menstration on GnRH Agonist Treatment for the Uterine Myoma

자궁근종의 성선자극호르몬분비호르몬 효능제 치료에 있어 생리의 영향

The aim of this study was to evaluate the effect of menstration among the influencing factors for the GnRH agonist (as G: depot goserelin 3.6 mg) therapy prior to the planned myomectomy for women who wanted to preserve their fertility. We reviewed total 48 patients. with the G therapy prior to the planned myomectomy from August 1st, 2005 to August 31st, 2006. The patients were classified by the G group (n=28) and the immediate surgery (as S) group (n=20). The G group (n=19) underwent the G therapy for 3 month courses, and then the efficacy was evaluated by menstruation and the myoma volumes. In the G group (n=19), therapy was effective, and the mean age was $32.4{\pm}6.5$ years. After the completion of G therapy, the mean volume of the myoma by ultrasonography was reduced to $85.2{\pm}71.2cm^3$ comparing of $430.6{\pm}248.8cm^3$ at first visit. The 11 patients had menstruation and the rest 8 patients with amenorrhea had less reduced volume of the myoma ($124.05{\pm}79.85cm^3\;v.s.\;329.41{\pm}234.0cm^3$ p<0.05). In the immediate S group, the myoma volumes by sonography was also checked for accuracy (${\alpha}=1.0$). As the result, the initial myoma volume had the positive correlations to the effectiveness with G therapy. However, the occurrence and frequency of the menstruation during the G therapy had a negative correlation. In conclusion, the use of G prior to the planned myomectomy was effective in reducing myoma volume and the menstruation.